The international encyclopaedia of surgery; a systematic treatise on the theory and practice of surgery . re contractionof the muscles attached to the sternum alone, shouldthe production of the fracture be ascribed. It is not always an easy matter to determine whetherthe lesion is an actual fracture, or merely a diastasisbetween the pieces of the sternum ; but the c^uestion isnot one of great practical importance. Occasionally,as in the specimen^ of which Fig. 597 is a representa-tion, the line of fracture clearly runs across one portionof the bone, with a marked degree of obliquity. Sometimes
The international encyclopaedia of surgery; a systematic treatise on the theory and practice of surgery . re contractionof the muscles attached to the sternum alone, shouldthe production of the fracture be ascribed. It is not always an easy matter to determine whetherthe lesion is an actual fracture, or merely a diastasisbetween the pieces of the sternum ; but the c^uestion isnot one of great practical importance. Occasionally,as in the specimen^ of which Fig. 597 is a representa-tion, the line of fracture clearly runs across one portionof the bone, with a marked degree of obliquity. Sometimes the displacement is very slight, but itmay be considerable ; and, in the great majority ofcases, the lower fragment projects in front of tlie mentions one case seen by Sabatier, in whichan old man had been subjected to great violence, andthrown into a hole thirty feet deep. lie fell on his Fracture of sternum. • Maryland Med. .lonrnal. Sopt. 1, 1882. « Op. cit., p. 9ot5. In the Mutter Museum of the College of Physicians of Philadelphia ; the specimen has noknown history. Fig. 00 INJURIES OF BONES. back; the second piece of the sternum was broken away from the first, anddriven in bcliind it. Tlie .^i/iiij)t(>iiis of this injury arc analogous to tliose of fractures of tlie ribsand their cartilages. Pain, tenderness, swelling, and ecchyniosis have beennoted in all the cases not immediately fatal. Cough almost always occure,and emphysema may exist independently of injury to the lung. lJis})lacementand crepitus have generally been more or less distinctly marked. Suppurationluis occasionally taken place in the anterior mediastinum. Riedinger^ says that repair, when it ensues, is etfected by means of a layerof tibro-cartilaginous material, placed between two other layers of hyalinecartilage. Very probably this statement may apply to cases of disruptionoccurring between two of the pieces ; but when a true fracture takes placein this bone, it is repaired in
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